Renal complications of jejuno-ileal bypass for obesity

Jejuno-ileal bypass has until recently been an accepted treatment for refra ctory morbid obesity. Although hyperoxaluria causing renal tract calculi is a well-recognized complication, we describe eight patients who developed s ignificant renal failure attributable to hyperoxaluria resulting from this procedure, three requiring renal replacement therapy. We review the literat ure, describing 18 other cases with renal failure, the mechanisms of hypero xaluria and its treatment. Because reversal of the bypass may result in sta bilization or partial improvement of renal function, these patients require long-term follow-up of renal function.